This is the third and last article in the series of “Expert Advice” from Tania Koerber, a Registered and Licensed Dietitian/ Nutritionist and Board Certified Specialist in Pediatric Nutrition! My Facebook friends were asked to share one question they would want answered by a Pediatric Nutritionist. The response was overwhelming in the number of replies, but also in the fact that we all have the same questions! The most popular topic was (not surprisingly) PICKY EATERS! Oh those stubborn little non-eaters of ours…
How did we get here, is there a way out of this tangled web of chicken nuggets and pasta with butter – and will they EVER eat and gain weight?
Tania’s expert answers:
The question is about “picky eaters” and some tips on how to handle them and help them gain weight (high calorie foods).
The term “picky eater” is lightly used by us parents and even medical providers.
- A true “picky eater” will exclude a whole food group (or groups) and have his/her caloric/nutrient intake affected in a way that growth and development can be compromised.
- In some occasions the culprit is medical, for instance in chewing/swallowing disorders or when sensory issues are present (in the case of ASD, Autism Spectrum Disorder), but in many cases the source of the problem is behavior – child and/or parents.
Food jags (and refusals), resistance to trying new foods and/or showing preference for certain foods are all part of a normal toddler and young child’s life.
- When parents watch their children refusing to eat or trying new foods, they start “giving in” afraid this eating pattern may affect growth and development.
- Young children do not have the cognitive skill or maturity to make right decisions about healthy eating.
- When they are asked “what would you like to eat?”, they will usually reply their favorite food, ranging from starchy snacks, like Cheetos, crackers to other starchy foods, such as mac and cheese, noodles or high fat proteins, like chicken nuggets and pizza.
- Usually vegetables are never part of the answer!
- When parents give in and offer their “favorite” on a daily basis, the message sent is that it’s ok to eat the same thing everyday instead of trying what everybody else in the family is eating.
- The picky eating behavior tend to only get worse over the years, and eventually this child will be very limited with choices at home (and outside the home).
- Early intervention with nutrition consult and/or behavior therapy is important to minimize nutrition deficiencies and stress over meal times.
Some of my tips to avoid “picky eating” or minimize it are:
- Involve your young child in the food preparation.
- Take your child whenever possible to a food/green market, let your child pick a different veggie or fruit.
- Look the nutrition information up on the web and talk about all “the nutrient power” in that food.
- Pick a recipe (recipe.com is great) using that food and try it at home.
- Involve your child in the preparation of the recipe. Young kids can break leaves with their hand, they can also wash vegetables or arrange it on the plate. Older children can help you mixing and adding ingredients together.
- Children who are involved in the preparation of meals, have less risk for picky eating!
- Allow your young child (as early as infancy!) to be at the table with the rest of the family.
- Family meals encourage young children to try new foods because they learn by example, and watching mom and dad eating a salad or a vegetable dish is the best motivation for them to want to have the same!
- Never ask your young child what they want to eat, instead give them 2 options for simple meals (like breakfast) or snacks, and offer only 1 meal at dinner time for the whole family using 1 starch or grain, 1 protein and at least 1 vegetable and fruit.
- Pick different combinations, alternating your child’s favorites with new foods.
- Praise for good behavior (trial of new foods, etc) but try to ignore poor behaviors (refusals, etc.).
- You can always make up the calories/nutrients with a nutritious “snack” at bedtime!
- Be consistent with your approach! Your child will learn that your “no”, really means “no”!
When underweight is present (BMI below the 5th percentile/age), increasing calories will be important.
- Some of the caloric boosters that can be used include: avocado, cheese, eggs, peanut/almond butter, butter, cream, mayo, etc.
- Some supplements are also available.
Again, if your child is not thriving (gaining weight), discuss your concerns with your child’s pediatrician and a consultation with a Pediatric Dietitian should be considered!
Don’t miss Tania’s two other articles:
Tania practices here in Palm Beach County where I met her years ago. She made a house call to us when I had some concerns about one of our boys. She spent a considerable amount of time giving me strategies, ideas and inspiration as to how we could navigate our concerns. I have recommended her services to many of my fellow “medical moms” over the years, and they have all been thrilled with her guidance. Tania is happy to do in-home consultations from Port St. Lucie to Boca Raton, Florida. Tania’s expertise ranges from addressing Failure to Thrive/ poor weight gain concerns, feeding difficulties (including picky eating) to Autism Spectrum Disorders (ASD), Chronic GI disorders, food allergies, sports nutrition – and everything in between.
Tania Koerber, RD, CSP, LD/N
Board Certified Specialist in Pediatric Nutrition
Contact Tania: firstname.lastname@example.org, (561) 313-9193